A successful return-to-work program

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A successful return-to-work program Powered By Docstoc
					        Ventura                                                                           www.twiw.com                   Managing
      Santa Maria                                                                                                          Risk
                                                                                                   CDI LIC.
        Salinas                                                                                    0E52073,

Claims Management                                                                                             Winter   2010

Successful Return-to-Work
Getting an injured worker back on the job as quickly as possible
makes good business sense and improves employee morale. How
do you develop a successful return-to-work program? What are the
pitfalls to avoid?

           successful return-to-work program       turn to work and what duties he or she will
           starts with a detailed company plan     be able to do. Detailed job descriptions are
           that has management support and         especially helpful if the injured worker has
           has been thoroughly discussed with      become disabled, making it relatively easy
employees so that they understand their role       to decide whether he can perform his old
in getting well and returning to work.             job—with or without accommodation.
                                                 Y A process for regular communications.
Three important components                         Open and regular communications among
of the plan should be:                             the injured worker, his supervisor, the doc-
Y Job descriptions and analyses for each           tor and the insurance company help keep
  job. Job descriptions and analyses give doc-     the worker’s treatment on track. When
  tors and insurance companies the tools to        workers know they are missed and that
  determine how soon an employee can re-                                  continued on next page
Claims Management                                                                                             Managing Risk • Winter 2010
  their managers are concerned about their      they return to work. For instance, “physical      job. The longer he stays home, the higher the
  recovery, they maintain a more positive       impairment,” a key part of the ADA defini-        chance he will malinger, finding physical rea-
  attitude and tend to return to work more      tion of disability, now includes major life ac-   sons to further delay his return. Immediately
  quickly.                                      tivities such as having difficulty in walking,    after a worker is injured, his manager should
Y Return-to-work agreement. Using an            standing, bending and lifting.                    use the worker’s job analysis to identify those
  agreement that clearly states the respon-         Workers with injuries that result in any      duties he may be able to perform while he
  sibilities of the employer and the injured    of those impairments are considered disabled      recovers. A return-to-work plan should allow
  worker will help employees understand         and require reasonable accommodation to           him to perform as many of his normal tasks
  what they need to do if they are injured.     perform their jobs. The workers are also usu-     as possible, while augmenting them with
  Both the employer and employee should         ally eligible to receive a workers’ compensa-     other work that will not affect his injury.
  sign the agreement.                           tion disability settlement.                           Insufficient budget: Some companies
                                                    FLMA rules: An injured employee may           make the mistake of not adequately funding
Pitfalls to Avoid                               choose to go on unpaid leave, rather than         return-to-work programs. Good programs
    Return-to-work programs can be a mine-      participate in an early return-to-work pro-       have costs. Someone has to manage the pro-
field of problems due to the variety of rules   gram. Under FMLA rules, the employer              gram, and you might have to hire extra em-
and regulations that apply, including the       must accept the leave, and the employee           ployees to do part of the injured worker’s job.
Americans with Disabilities Amendment Act       retains the right to have her job back after      However, return-to-work programs actually
of 2008 (ADAA), the Family Medical Leave        returning from FMLA. (The good news is            save money because employees are back at
Act (FMLA) and various state workers’ com-      that the company can usually stop making          work sooner. Savings also come from:
pensation laws.                                 the workers’ comp indemnity payments dur-
    ADA issues: ADAA significantly ex-          ing the leave.)                                   Y Lowering the odds of expensive
panded the definition of disabilities under         Long employee absence: When com-                litigation.
the Americans with Disabilities Act (ADA),      panies are not able to develop a light-duty       Y Reducing claims reserves.
so employers should expect more injured         schedule for an injured worker, the worker        Y Reducing the injury’s impact on the
workers to be classified as disabled when       stays at home until ready to resume his old         company’s workers’ comp experience
                                                                                                    modification and insurance rates.

                                                                                                      Difficulties in following mandatory
                                                                                                  medical exams: Companies need to follow
                                                                                                  strict guidelines for medical exams that are
                                                                                                  used to release employees back to work—for
                                                                                                  both full-time and light-duty assignments.
                                                                                                      If you would like advice on how to de-
                                                                                                  velop a successful return-to-work program,
                                                                                                  give us a call.
Loss Prevention                                                                                                  Managing Risk • Winter 2010

Preventing Workers’
Comp Fraud
Workers’ comp fraud costs businesses anywhere from $5 billion to
$7 billion each year. What are the warning signs to look for? How
can you keep your company from being ripped off?

            woman who drove a bus for a pri-     Any one sign may not indicate a problem,
            vate company in California hurt      but if you see several, you need to investigate.
            her back and went on workers’        Be aware of employees who:
            comp leave. After several months
of physical therapy, it looked like she would    4   Do not have a witness to their injury.
have to go on long-term disability. The insur-   4   Delay reporting the injury.
ance company was negotiating a settlement        4   Have discrepancies in their story.
when the employer got a tip: the woman was       4   Are vague on details, and the details
training for a golf tournament and giving            change.
golf lessons at a nearby course. A surveil-      4   Report being injured on a Monday.
lance company was hired to video the bus         4   Report an injury just prior to a layoff.
driver’s beautiful swing. She was nailed.        4   Do not return calls.                           derstand that the claims costs are ultimately
    Most cases of workers’ comp fraud are        4   Cancel doctor’s appointments.                  paid by the company. These expenses affect
not that outrageous. However, some em-                                                              profits and can contribute to cost-cutting
ployees seem to have relatively little concern   Preventing Fraud                                   measures, especially in a tough economy.
about cheating their employers. According            The first place to fight workers’ comp             Finally, employees need to know that
to the National Insurance Crime Bureau           fraud is on the front line – with your employ-     workers’ comp fraud is a felony (in most
(NICB), “opportunistic fraud,” in which          ees. They need to believe that the company is      states), and that you will prosecute any em-
claimants pad their workers’ comp claims,        committed to a safe, healthy work environ-         ployees who try to defraud the company.
increased 28 percent in the first quarter of     ment. They need to know they are receiving             You might want to cite some local statis-
2009. The NICB attributes the increase to        good training, so they can perform their jobs      tics. For instance, last year California district
the bad economy.                                 in a consistently safe manner.                     attorneys convicted 527 people of workers’
                                                     Next, you need to make sure your em-           comp fraud. The typical sentence was a few
Warning Signs                                    ployees understand the role of workers’ comp       days in county jail, plus many hours of com-
   There are many warning signs that em-         insurance and that it represents a significant     munity service, several years of probation, a
ployees are committing workers’ comp fraud.      cost to the company. Employees need to un-         civil fine and restitution of funds.
                                                                                                                              continued on next page
Liability                                                                                                        Managing Risk • Winter 2010
    Employees need to know that it doesn’t         ing strenuous physical activities or working      that track all references to a person – more
pay to commit workers’ comp fraud. If they         a second job.                                     thoroughly than a Google search. Some em-
are caught, it’s a felony, it’s embarrassing and       In the case of the bus driver who gave        ployees brag online about their insurance
they have to repay the money.                      golf lessons, Patty Kotze, managing partner       scams. Others simply provide information
                                                   at Diversified Risk Management in Downey,         that leads to surveillance.
Investigating Fraud                                Calif., handled the surveillance. She signed          According to Kotze, it is important to
    Many insurance companies now use so-           up for lessons and then made sure her teach-      understand privacy issues when doing a Web
phisticated software to detect fraud as soon       er demonstrated how to properly swing the         search. “It’s not ethical to become someone’s
as the first notice of loss is filed. When that    club. “I had to take several lessons,” Kotze      Facebook friend and then investigate their
happens, your carrier may call you before          said. “You have to be able to prove that the      activities,” Kotze said.
you call them.                                     suspect’s agility was not a one-day fluke –           If you suspect fraud, contact our agency
    Insurers also hire outside investigators to    that she was able to play golf every day.”        or your workers’ comp carrier as soon as pos-
conduct legal surveillance of suspected cheats.        Some investigators also comb through In-      sible. The insurance company will take the
They use GPS, night-vision lenses and other        ternet sites such as Facebook to track the ac-    lead in investigating, but will need your con-
high-tech electronics to record workers do-        tivities of suspects. They use “Web crawlers”     tinuing help.
Risk Management

Managing Telecommuting Risks
Telecommuting has evolved from an occasional employee perk to
a mainstream business strategy. Is it right for your company? What
are the risks and how do you manage them?

                ore than 12 million people         about losing control of workers who would
                worked outside their offices at    be slacking off at home. However, with the
                least once a month in 2008,        confluence of high-speed broadband, porta-
                an increase of 39 percent in       ble devices and increased gas prices, telecom-
two years, according to the WorldatWork            muting has taken off.
Institute. Not surprisingly, technology com-           Companies like Cisco have formal tele-
panies led the way. A 2006 survey of Cisco         commuting programs, but many other com-
Systems employees found that their average         panies have ad hoc arrangements that expand
employee telecommuted two days a week.             over time, as managers see the advantages.
    Originally, many managers were skep-           Today, there are three compelling reasons for
tical about telecommuting. They worried            telecommuting:
                                                                            continued on next page
Risk Management                                                                                           Managing Risk • Winter 2010
1 Save money. Telecommuting lowers real
  estate and other employee-related costs.       Swine Flu and Telecommuting

2 Increase efficiency. Studies show that a
                                                        ocial distancing—increasing the         4 Identify which portion of specific job
  significant portion of the time saved from
                                                        physical distance between people          functions can be done at home.
  commuting is used for work.
                                                        to reduce the spread of disease – is    4 Discuss the plan with all employees,
3 Increase employee morale and retention.
                                                 a key phrase in this year’s strategy to min-     explaining why some jobs are suitable
  Telecommuting employees are generally
                                                 imize the spread of the swine flu, H1N1,         for telecommuting and others are not.
  more satisfied with their work and feel
                                                 according to the U.S. Centers for Disease      4 Test the plan with eligible employees
  less stressed.
                                                 Control (CDC).                                   by having them telecommute several
                                                     Depending on the severity of the epi-        times prior to their needing to stay
    Telecommuting makes more sense for
                                                 demic, health officials may recommend            home.
companies in which many employees are
                                                 closing schools and child care centers,        4 Encourage all employees to stay home
engaged in “heads down” activities such as
                                                 canceling large business meetings, spac-         when they have the flu.
computer programming, legal research or
                                                 ing workers farther apart in the workplace,
graphic design that require relatively little
                                                 canceling non-essential travel, and imple-        For more information on planning for
interaction with others.
                                                 menting work-from-home strategies.             the flu season, see www.PandemicFlu.
The Security Risks                                   The CDC also encourages employ-            gov.
                                                 ers to allow employees to stay home to
    Employees working remotely generally
                                                 care for family members. Those healthy
have access to company information via a
                                                 employees are prime candidates for tele-
company laptop or their own personal com-
                                                     Whether or not winter brings an epi-
    A 2007 study by Ernst & Young and the
                                                 demic of swine flu, companies should
Center for Democracy and Technology found
                                                 plan for the worst case. For many that will
that more than 80 percent of respondents al-
                                                 mean taking the first steps to develop a
lowed telecommuters to work at home with
                                                 telecommuting program.
proprietary or confidential information.
                                                     If you do not have a formal telecom-
Those workers share some of the same secu-
                                                 muting program, it is important to imme-
rity risks as employees who travel:
                                                 diately assess which employees have job
                                                 functions that could be done from home.
Y Physical loss of information or a laptop
Y Access to data by unauthorized people
Y Communication through non-secure
                                                 4 Develop guidelines and procedures
                                                   that protect the security of company
    Home workers pose additional security
                                                   property and data.
risks if they:
                        continued on next page
Risk Management                                                                                                Managing Risk • Winter 2010

Y Store proprietary information on unpro-            nect to the company’s network, including       Y Electronic fraud—reimbursement for
  tected computers.                                  wireless devices and home computers.             money stolen through the computer.
Y Print confidential information without         Y   Use hard token authentication for server
  proper disposal.                                   and database access.                              If you are thinking about making tele-
Y Allow family members to use the com-           Y   Prohibit downloading unauthorized soft-        commuting an important component of
  pany’s computer.                                   ware on company computers.                     your business strategy, give us a call so we
Y Allow others to use critical passwords.        Y   Provide email encryption if workers use        can discuss risk management and your cur-
                                                     home computers for work.                       rent coverages.
What to Do                                       Y   Monitor telecommuters’ email and access
   If you have employees who telecom-                to the Internet and company databases.
mute—even just occasionally—you need to
have a written telecommuting policy that ad-
                                                 Insurance Concerns
dresses the specific needs of your company
and the specific activities employees do at
                                                      The good news is that having work-
                                                 ers telecommute does not generally require
home. You need to:                               buying any additional insurance coverage or                     Risk
Y Establish whether employees can handle              It is easy to imagine insurance risks for
  private or proprietary data remotely.          employees working at home – an employee
Y Establish security credentials and access      falls down her stairs and has a workers’ comp
  controls for remote workers, based on          injury, or she drives to the post office and has
  their specific needs for access to confiden-   a car accident. Those scenarios are rare and
  tial information.                              are generally covered by existing policies.
Y Discourage printing at home, but estab-             Regardless of whether your employees are
  lish guidelines for disposal.                  working at home, you may want to look at
Y Prohibit employees from using personal         your coverage limits for computer hardware
  computers unless security features have        and consider optional endorsements that add
  been installed.                                coverage for:
Y Prohibit employees from storing compa-
  ny information on their home comput-           Y Loss of software, programming and data
  ers.                                             caused by viruses
Y Prohibit employees from transferring           Y Loss of income due to damaged hardware
  data through USB flash drives, unless en-        or software caused by viruses
  crypted.                                       Y Loss of income due to viral attacks that
Y Use encryption, such as a virtual private        overload computers and prevent normal
  network (VPN), for all devises that con-         business traffic